Task-dependent changes in brain activation following therapy for nonfluent aphasia: Discussion of two individual cases
Task-dependent changes in brain activation following therapy for nonfluent aphasia: Discussion of two individual cases
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DOI：
10.1017/s1355617706061017
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发表时间：
2006-11-01
影响因子：
2.6
通讯作者：
Small, Steven L.
中科院分区：
文献类型：
--
作者：
Cherney, Leora R.;Small, Steven L.
失语症恢复过程中语言相关脑区皮质重组的复杂过程以及治疗干预对脑系统的影响尚不清楚。我们研究了两名慢性失语症患者，并将他们的功能神经解剖反应与年轻对照组进行了两项任务的比较，一项是涉及公开演讲的口头阅读任务，另一项是“被动”视听故事理解任务。在相同的治疗后，我们使用相同的功能性磁共振成像（fMRI）任务重新检查了行为（语言）和功能性神经解剖学变化。我们假设，更好的恢复将与大脑激活模式更接近健康对照组，而积极的语言治疗反应将与未受损的左大脑外侧裂周区和/或右半球地区同源的受损地区的活动增加。对于额叶损伤的参与者谁是最响应的治疗，大脑激活增加在右半球在口头阅读，但减少在大多数地区的故事理解。另一名颞顶叶损伤的参与者在口头阅读时表现出活动减少，特别是在右半球，但在故事理解时双侧活动增加。结果突出了语言治疗后的个体差异，大脑激活的变化取决于病变部位和大小，语言技能，干预类型和功能磁共振成像任务的性质。
The complex process of cortical reorganization of language-related brain regions during recovery from aphasia and the effects of therapeutic interventions on brain systems are poorly understood. We studied two patients with chronic aphasia and compared their functional neuroanatomical responses to a younger control group on two tasks, an oral-reading task involving overt speech and a "passive" audiovisual story-comprehension task. Following identical therapy, we re-examined behavioral (language) and functional neuroanatomical changes using the same functional magnetic resonance imaging (fMRI) tasks. We hypothesized that better recovery would be associated with brain activation patterns more closely resembling healthy controls, whereas positive responses to language treatment would be associated with increased activity in undamaged left perisylvian areas and/or right-hemisphere areas homologous to the damaged regions. For the participant with a frontal lesion who was most responsive to therapy, brain activation increased in the right hemisphere during oral-reading, but decreased bilaterally in most regions on story-comprehension. The other participant with a temporal-parietal lesion showed decreased activation, particularly in the right hemisphere, during oral-reading but increased activation bilaterally on story-comprehension. Results highlight individual variability following language therapy, with brain activation changes depending on lesion site and size, language skill, type of intervention, and the nature of the fMRI task.